Study presented at the 3rd Congress of the European Academy of Neurology

Amsterdam (ptp011/27.06.2017/09:00) - It has long been supposed that patients with metabolic syndrome are more likely to suffer from cognitive impairment - and to a greater extent. Reasons are thought to include chronic inflammatory processes which can induce neuroinflammatory and neurodegenerative changes. Whether obese individuals without risk factors such as diabetes mellitus, metabolic disorders and the presence of albumin in the urine have an increased risk of cognitive impairment is still little researched.

A group of Israeli researchers analysed 60 obese individuals with a body mass index of over 30 in two groups: the members of the first group had a maximum of one component of metabolic syndrome, while those in the second group presented two or more. The Montreal Cognitive Assessment Score (MOCA) was used to determine cognitive dysfunction, if any.

Obesity alone not a risk factor for cognitive disorders

The results of the study presented at the 3rd Congress of the European Academy of Neurology (EAN) in Amsterdam clearly showed that while cognitive ability is not necessarily determined by overweight, it is influenced by the risk factors that go with it. "There is a clear association between metabolic risk factors and cognitive impairment," summarised the study's authors Dr Radi Shahien and Dr Aleh Abu Salach from the Ziv Medical Centre in Safed, Israel. Of the 30 patients with several components of metabolic syndrome, 13 per cent had dementia, 51 per cent milder forms of cognitive impairment and 36 per cent showed no signs of cognitive dysfunction. In the control group of metabolically healthy obese individuals, more than 90 per cent had a normal cognitive score, 7 per cent showed mild impairment and the remainder had already developed dementia.

Age and abdominal girth the main risk factors

Looking at the results in detail, it emerged that abdominal girth and age were the greatest risk factors. That said, there was also a strong correlation between cognitive score, and high blood pressure and liver stiffness. "Additional studies need to be undertaken to show whether treatment of individual factors in metabolic syndrome can improve cognitive function," Dr Shahien added.

Dementia treatment worse among diabetes patients

Another study presented at the EAN Congress in Amsterdam examined a different correlation. A research group from the Karolinska Institute in Stockholm wanted to investigate the clinical characteristics of diabetes mellitus in a large cohort of dementia patients. The study conducted by Prof Dorota Religa and Dr Juraj Secnik included 29,630 patients with cognitive impairments, 4,881 of whom were also diagnosed with diabetes mellitus.

Patients who were younger when they received their dementia diagnosis were more likely to suffer from diabetes, with more men affected than women. Vascular dementia or a mixed form of vascular dementia and Alzheimer's disease were also more common in diabetes patients. On the other hand, Lewy body dementia and Parkinson's dementia were both less common among diabetes patients.

The study also found that patients with diabetes not only received less treatment with antidepressants but also obtained significantly less Alzheimer's medication. "This could show less optimal dementia treatment among diabetes patients than in others," suggested Prof. Dorota Religa, before issuing a call for additional studies to focus on these aspects. "We have further developed the study and the manuscript was accepted for publication in Diabetes Care, the official journal of the American Diabetes Association.